Contract Pharmacy Details

RITE AID OF NEW HAMPSHIRE, INC.
CH0112220 LITTLE RIVERS HEALTH CARE, INC.

Covered Entity Details

Entity Name

LITTLE RIVERS HEALTH CARE, INC.

Subdivision Name

Wells River

Type

HRSA-Funded Health Center

340B ID

CH0112220

Entity Address

65 Main St N
Wells River, VT 05081

Grant Number

H80CS06658

Participating Start Date

10/1/2006

Last Recertification Date

2/10/2025

Pharmacy Details

Pharmacy Name

RITE AID OF NEW HAMPSHIRE, INC.

Pharmacy Address

RITE AID #4871
4976 DARTMOUTH COLLEGE HIGHWAY
WOODSVILLE, NH 03785

Pharmacy Comments

Contract Details

Approval Date

12/6/2012

Contract Begin Date

1/1/2013

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

5/20/2020
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

GAIL AUCLAIR, CEO
(802) 222-4637 Ext: 104

Contract Pharmacy Representative

Rite Aid
Tammy Royer, Group Vice President, Managed Care
(717) 730-8217

Signed By Date

10/15/2012

340B Drug Pricing Program Database